title: Catheter related blood stream infections in the paediatric intensive care unit: A descriptive study.
abstract: BACKGROUND
  Catheter related blood stream infections (CRBSI) contributes significantly to morbidity, mortality and costs in intensive care unit (ICU). The patient profile, infrastructure and resources in ICU are different in the developing world as compared to western countries. Studies regarding CRBSI from pediatric intensive care unit (PICU) are scanty in the Indian literature.
  
  
  OBJECTIVE
  To determine the frequency and risk factors of CRBSI in children admitted to PICU.
  
  
  METHODS
  Descriptive study done in the PICU of a tertiary care teaching hospital over a period of four months.
  
  
  METHODS
  Study children were followed up from the time of catheterization till discharge. Their clinical and treatment details were recorded and blood culture was done every 72 h, starting at 48 h after catheterization. The adherence of doctors to Centre for Disease Control (CDC) guidelines for catheter insertion was assessed using a checklist.
  
  
  METHODS
  Clinical parameters were compared between colonized and non-colonized subjects and between patients with and without CRBSI. Unpaired t-test and Chi-square test were used to test the significance of observed differences.
  
  
  RESULTS
  Out of the 41 children, 21 developed colonization of their central venous catheter (66.24/1000 catheter days), and two developed CRBSI (6.3/1000 catheter days). Infants had a higher risk for developing colonization (P = 0.01). There was 85% adherence to CDC guidelines for catheter insertion.
  
  
  CONCLUSIONS
  The incidence of CRBSI and catheter colonization is high in our in spite of good catheter insertion practices. Hence further studies to establish the role of adherence to catheter maintenance practices in reducing risk of CRBSI is required. The role of a composite package of interventions including insertion and maintenance bundles specifically targeting infants needs to be studied to bring down the catheter colonization as well as CRBSI rates.
authors.affiliation: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Diana
authors.initials: D
authors.lastname: Thomas
authors.forename: Narayanan
authors.initials: N
authors.lastname: Parameswaran
authors.forename: B N
authors.initials: BN
authors.lastname: Harish
keywords: Catheter related blood stream infections; nosocomial infections; pediatric intensive care unit